16_Exhibit_L-4_Sample_Coverletter_Past_Perform_Quest.doc

Exhibit L-4 Sample Cover Letter

PAST PERFORMANCE QUESTIONNAIRE

(The format to be used shall be substantially as follows: Printed on Company Letterhead)

Company:

Date

Address:

1. We are submitting a proposal for a solicitation from the TRICARE Management Activity (TMA), Contract Operations Division, Aurora (COD-A), CO, as the prime offeror or subcontractor on prime offeror’s team*. The solicitation is for TRICARE Dual-eligible Fiscal Intermediary Contract (TDEFIC). This solicitation requires us to provide past performance information. Please complete the attached past performance questionnaire and return it via email or mail to:

a. Mail:

TMA/COD-A

Attn: Contracting Officer (TDEFIC HT9402-12-R-0005) 16401 E Centretech Parkway

Denver CO 80011

b. e-mail: margaret.zancanella@tma.osd.mil AND scott.lamond@tma.osd.mil

2. In order to ensure this questionnaire is considered, please forward this questionnaire to arrive at the TMA/COD-A contracting office no later than XXXX 2012. Upon completion, please notify my office at __________ (phone number) that you completed and submitted the questionnaire to the contracting office.

Name & Title of Individual

Name of Company

1 Attachment:

1. Past Performance Questionnaire

* To facilitate proposal evaluation, the offeror or its first-tier subcontractor/teaming partner shall CLEARLY state the offeror’s name under which the proposal is submitted to the Government. The past performance questionnaire may not be considered if the Government cannot determine whose past performance or the offeror team to which the past performance belongs.

TDEFIC, HT9402-12-R-0005, Exhibit L-4 Cover Letter to Past Performance Questionnaire